Factor Associated with Incorrect Diagnosis of Margins in Undifferentiated Type Early Gastric Cancer:Clinical Approach for Difficult Cases Kazunori Takada 1 , Yohei Yabuuchi 1 , Masao Yoshida 1 , Noboru Kawata 1 , Naomi Kakushima 1 , Kohei Takizawa 1 , Yoshihiro Kishida 1 , Sayo Ito 1 , Kenichiro Imai 1 , Kinichi Hotta 1 , Hirotoshi Ishiwatari 1 , Hiroyuki Matsubayashi 1 , Hiroyuki Ono 1 1Shizuoka Cancer Center, Division of Endoscopy, Shizuoka, Japan Keyword: 早期胃癌 , 未分化型癌 , 陰性生検 , 範囲診断 , NBI pp.50-59
Published Date 2020/1/25
DOI https://doi.org/10.11477/mf.1403201926
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 We aimed to investigate the factors associated with incorrect diagnosis of margins in UD-EGC(undifferentiated type early gastric cancer). We analyzed 282 lesions preoperatively diagnosed as UD-EGC that had undergone ESD(endoscopic submucosal dissection)between September 2002 and December 2017. We defined lesions with correct diagnosis of margin as the dissected lesion within the markings placed before ESD. We defined “negative biopsies” as biopsy samples taken from non-cancerous tissues around the lesion to determine resection margins before ESD. Logistic regression analysis was performed to identify preoperative factors related to incorrect diagnosis of margin. There were 29 lesions(10.3%)with an incorrect diagnosis of margin. Multivariate analysis revealed lesions located in the middle third of stomach, no use of NBI(narrow band imaging), and positive result for malignancy in negative biopsies to be significant factors associated with incorrect diagnosis of margin. We should use NBI and confirm negative result for malignancy in negative biopsies before conducting ESD for UD-EGC.

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